EP2341861B1 - Vorrichtung zur herstellung von anastomosen sowie koagulationselektrode - Google Patents

Vorrichtung zur herstellung von anastomosen sowie koagulationselektrode Download PDF

Info

Publication number
EP2341861B1
EP2341861B1 EP09777405.3A EP09777405A EP2341861B1 EP 2341861 B1 EP2341861 B1 EP 2341861B1 EP 09777405 A EP09777405 A EP 09777405A EP 2341861 B1 EP2341861 B1 EP 2341861B1
Authority
EP
European Patent Office
Prior art keywords
sleeve
lamellae
closed state
hollow organ
hollow
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Not-in-force
Application number
EP09777405.3A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP2341861A1 (de
Inventor
Achim Brodbeck
Lothar Mitzlaff
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Erbe Elecktromedizin GmbH
Original Assignee
Erbe Elecktromedizin GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Erbe Elecktromedizin GmbH filed Critical Erbe Elecktromedizin GmbH
Priority to EP13191846.8A priority Critical patent/EP2710973B1/de
Priority to PL13191846T priority patent/PL2710973T3/pl
Priority to PL09777405T priority patent/PL2341861T3/pl
Publication of EP2341861A1 publication Critical patent/EP2341861A1/de
Application granted granted Critical
Publication of EP2341861B1 publication Critical patent/EP2341861B1/de
Not-in-force legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1402Probes for open surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1103Approximator
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00184Moving parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589Coagulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00619Welding

Definitions

  • the invention relates to a device for producing anastomoses according to the preamble of claim 1 and a coagulation electrode according to claim 11.
  • An anastomosis is a connection between two anatomical structures.
  • severed blood vessels may be connected by anastomoses during organ transplantation.
  • connection can be made using suture techniques.
  • approaches that allow an organic compound by means of adhesive techniques. Frequently fibrin sealants are used, which allow a very advantageous combination of organs, in particular hollow organs.
  • fibrin sealants are used, which allow a very advantageous combination of organs, in particular hollow organs.
  • compatibility of these adhesives is problematic because they can have thrombogenic and toxic properties.
  • Clamping techniques are also used to connect at a suitable location.
  • Various aids such as rings, cuffs or stents, are used to assist in performing anastomoses.
  • WO 03/061487 A1 It is known to connect hollow organs by the application of a suitable high-frequency current (RF current).
  • RF current high-frequency current
  • the WO 03/061487 A1 an instrument with an inner sleeve and an outer sleeve ready. These sleeves each include an electrode which is annular and to which the RF current is applied. So it is a bipolar RF instrument.
  • the first end is passed through the inner sleeve and folded over so that the tissue comes to rest on the outside of the inner sleeve.
  • the second end of the vessel is pulled over the inner sleeve and the end portion of the blood vessel thereon.
  • the outer sleeve can be opened and put over the inner sleeve and the tissue located thereon.
  • the electrodes are arranged on the sleeves such that the first end and the second end of the vessel are clamped between the electrodes at the sleeves. When the HF current is applied, it flows through the tissue and fuses the ends.
  • a problem of WO 03/061487 A1 is that for welding or coagulation of hollow organs with different diameters, a plurality of differently ausgestalteter instruments are needed.
  • the gap between electrodes and sleeves must be dimensioned such that it is adapted to the diameter of the wall thicknesses.
  • the coagulation process requires a sustained pressing of the tissue structures or vessel end sections throughout the coagulation process.
  • the present invention solves this problem by the device according to claim 1.
  • the object is achieved by a device for producing anastomoses between a first and a second hollow organ, each having an inner and an outer surface, comprising a sleeve with an inner electrode assembly over which the first hollow member is everted so that its inner surface after comes to lie outside, and an outer electrode assembly, which is the inner electrode assembly in particular radially opposite and with the second hollow member, which is pushed over the first hollow member, can be brought into electrical contact, that the electrode assemblies contact outer surfaces of the hollow organs, wherein the outer electrode assembly has a plurality of at least one guide member against each other movable slats comprises, which are designed and movable such that inner edges of the slats in a closed state form a through hole and abut the second hollow organ and in a ⁇ Stammsz a gap leading from the outside to the passage opening is formed between the lamellae, through which the interconnected hollow organs can be led out of the passage opening to the outside.
  • the outer electrode is formed by a plurality of mutually movable blades.
  • the fins are arranged so that they can assume at least two states, a closed state and an open state.
  • the opening state at least the lamellae are spaced apart from the sleeve with the inner electrode arrangement in such a way that a through opening is formed in which the corresponding sections of the hollow organs can be positioned, preferably still with a substantial absence of tissue contact and radial force.
  • the inner edges of the slats are at least partially on the hollow organ and allow direct application of the HF current.
  • the outer electrode arrangement with the lamellae is divisible.
  • a gap can form, which divides the slats. Due to the gap, the unconnected hollow organ or vessel can be introduced or the connected removed from the device.
  • the lamellae can exert a mechanical pressure on the hollow organs.
  • the closing and coagulation conditions can be determined relatively accurately. This can ensure the formation of anastomoses with a high load capacity. After a connection of the hollow organs can be easily removed in the open state, the device. Injury to the organs or excessive loading of the compound produced is avoided.
  • the lamellae can be adjustable in such a way that, in the closed state, an opening is created which corresponds to the hollow organ to be treated.
  • hollow organs can be treated, which have different dimensions.
  • blood vessels with different diameters can be treated.
  • An instrument may be suitable for connecting veins and arteries.
  • the lamellae can be constructed and / or arranged in the manner of an iris diaphragm.
  • the passage opening is thus constructed substantially circular. This is advantageous for a large number of applications, for example in the connection of vessels.
  • an iris diaphragm is particularly suitable for providing a substantially continuous contact surface of the lamellae.
  • An applied mechanical pressure can be regularly distributed over the outer and surface of the second hollow organ.
  • the sleeve can be arranged fixed relative to the outer electrode in a holder or a holder.
  • the sleeve is in a predetermined position relative to the outer electrode. Positioning the sleeve relative to the outer electrode is thus unnecessary.
  • the device according to the invention can be constructed much more compact by the fixation in a holder. The handling is facilitated by the fixed or adjustable positioning.
  • the holder may be removable for individual handling of the sleeve. That is, the holder can be detached from the device and operate separately from this.
  • the sleeve and device may be coupled such that the sleeve is in an advantageous position relative to the outer electrodes. After this Coagulation process, it may be advantageous to solve the holder back from the device in order not to unnecessarily straining the connected hollow organs.
  • the inner edges of the slats may have a substantially equal distance to the sleeve in the closed state. In the closed state, therefore, the inner edges lie on the second hollow organ, in particular on its inner surface.
  • the HF current is applied directly to the tissue. The connection achieved is correspondingly higher quality.
  • the passage opening can be adjustable in terms of its diameter by moving the slats.
  • the device can thus be opened and closed by moving the slats.
  • the gap may, in the open state, divide the outer electrode into two halves which are movable away from each other.
  • an iris diaphragm which can be divided, for example, in two semicircles. The gentle removal of the device after a coagulation process is thus facilitated.
  • the sleeve can be held on an actuating device and designed such that it can be dismantled into two parts such that the parts can also be brought from a closed state to form a closed tubular section into an open state for removal from the hollow organ.
  • the sleeve can therefore be designed in two parts, so that it can be disassembled after or before the application of the HF current. For example, it may be possible to spread apart the individual parts of the sleeve to ensure better handling of the organs. The spreading of the sleeve can also prevent the slipping of the hollow organ which has been slipped over the sleeve.
  • the actuator may be biased in a closed state.
  • the closed state automatically turns on.
  • the slats can be biased by a clamping device in the closed state with a defined force.
  • the clamping device can be adjusted such that the slats are pressed in the closed state with a predefined force against the hollow organs. This force not only allows a safe coagulation of the tissue, but is also sized so that there is no injury to the hollow organs. By adjusting the tensioning device, a repeatability of the treatment results can be ensured.
  • Such a coagulation electrode has similar advantages to those of the device described above.
  • the coagulation electrode is divisible and thus easily removable after the application of the HF current. That is, the coagulation electrode is easily removed from the connected hollow organ.
  • the link ring can also be a lamella and take over their functions.
  • the slide ring may comprise slide ring sections which are each movable separately from one another, in particular by guide rods.
  • the link ring may comprise exactly two link ring sections which form the link ring.
  • the sections can be used to operate the slats.
  • the lamellae can be rotated by means of the sections opposite the bearing ring (preferably comprising two bearing ring sections). The slats are brought into the opening or closing state.
  • Fig. 1 shows an electrosurgical instrument 10 for the production of anastomoses.
  • the instrument 10 comprises a base plate 13 on which branches 12, 12 'are rotatably mounted.
  • a closure device 20 serves to actuate the Branches 12, 12 '.
  • This comprises a closure actuating element 24, which is connected via a slotted guide with the branches 12, 12 '.
  • the shutter actuator 24 has substantially two positions, a first position in which the electrosurgical instrument 10 is opened and a second position in which the electrosurgical instrument 10 is closed.
  • the closure device 20 is designed such that the branches 12, 12 'are fixed in the second position, so that unintentional opening of the electrosurgical instrument 10 is not possible (cf. Fig. 2 ).
  • the electrosurgical instrument 10 has a clamping device 40 for actuating the iris diaphragm 50.
  • This tensioner 40 comprises a tensioner actuator 42, a force deflector 44 rotatably mounted on the base plate 13, a tension spring 41, and two actuators 52, 52 '.
  • the adjusting elements 52, 52 ' each extend along the first branch 12 or the second branch 12' and transmit the forces exerted by the tensioning device 40 on the mechanics of the iris diaphragm 50.
  • the tensioning device 40 is also in the open position of the electrosurgical instrument 10 in an open position (cf. Fig. 1 ). In the second, closed position of the electrosurgical instrument 10, the tensioner 40 can be tensioned by operating the tensioner actuator 42.
  • FIG. 3 shows the tensioner actuator 42 in a tensioned condition.
  • the tension spring 41 connected to the force deflector 44 is tensioned.
  • the rod or the adjusting elements 52, 52 ' which attach substantially point-symmetrically to this pivot point on the force deflector 44, perform a translational movement in proximal (actuator 52') and distal (actuator 52) direction. As further explained below, this movement leads to a closing and opening of the iris diaphragm 50.
  • the tension spring 41 in the tensioned state via the adjusting elements 52, 52 ' continuously exerts a force on the mechanism of the iris diaphragm 50.
  • the amount of this force can be controlled by a Sch thoroughlykrafteinstellvorraum 45 (see. Fig. 3 ) to adjust.
  • the embodiment of the force deflector 44 according to the Fig. 3 For this purpose, a multiplicity of bores, which have different distances from the pivot point of the force deflector 44, are included.
  • the tension spring 41 is designed such that it can be anchored in the individual holes. Thus, the spring force of the tension spring 41 depending on the position in the holes with a different lever to the force deflector 44. As in Fig.
  • the force deflector 44 projects beyond the base plate 15 so that it is manually operable.
  • the iris diaphragm 50 can also be closed and opened in the non-tensioned state via the force deflector 44, which serves as an actuating element.
  • Fig. 4 shows a further embodiment of the clamping device 40.
  • the Schellerkrafteinstellvorraum 45 includes a screw 46 and an angle 47.
  • the angle 47 is fixed to the force deflector 44 that this can be moved by operating the screw 46 along a longitudinal axis.
  • the tension spring 41 is applied to the angle 47.
  • a positioning device 30 (cf. Fig. 5 ). This comprises a sleeve 32 for receiving the hollow organs and two sleeve actuation branches 35, 35 '.
  • the positioning device 30 essentially serves to position the hollow organs in the center of the iris diaphragm 50. Furthermore, it provides a sleeve electrode 36.
  • the sleeve 32 is substantially cylindrical and comprises a first sleeve portion 33 and a second sleeve portion 33 '. In cross section, transverse to the longitudinal axis of the sleeve 32, the sleeve portions 33, 33 'each form a semicircle.
  • the sleeve portions 33, 33 ' are connected to the sleeve actuating industries 35 and 35', respectively. These are rotatably attached to a removable portion 13 'of the base plate 13 that the sleeve portions 33, 33' open and close. In the closed state, the sleeve portions 33, 33 'abut each other and form the sleeve 32. Thus, the positioning device 30 can be opened and closed via the sleeve actuation branches 35, 35'.
  • the sleeve actuating industries 35, 35 ' acted upon by a spring force which holds the sleeve sections 33, 33' closed.
  • the removable portion 13 ' are mounted rotatably on the sleeve actuating industries 35, 35', is connected via a plug connection with the base plate 13.
  • the positioning device 30 can be detach from the other components of the electrosurgical instrument 10 and handle individually.
  • the divisibility of the sleeve 32 is particularly advantageous when applying and removing the instrument 10 to the hollow organ.
  • the sleeve 32 comprises at least two mandrels 28, which are arranged radially to the longitudinal axis of the sleeve 32 and on the sleeve portions 33, 33 '. If the hollow organ or its sections are pushed over the sleeve 32, then the pins 28 fix the hollow organs or vessels which have been pushed over. Their feed is limited by the sleeve operating industries 35, 35 '.
  • the detachable section 13 ' can be reconnected to the base plate 13 and brought into a position suitable for connecting the sections of the hollow organ.
  • an essential point of the present invention is to construct the device head of the electrosurgical instrument 10 in the form of a divisible iris diaphragm.
  • the iris diaphragm 50 comprises two half-screens 51, 51 ', which cooperate in the closed state as an iris diaphragm 50.
  • the structure of a half-stop, namely the half-stop 51 is in the Fig. 6 illustrated.
  • This comprises a mounting plate 56, which is formed substantially semicircular and fixed to the first sector 12 is connected.
  • a likewise semicircular shell 57 extends.
  • the shell 57 has an opening 60 through which a crescent-shaped adjusting disk 54 projects into the interior of the half-aperture 51.
  • the adjusting disc 54 can be actuated such that it performs a circular movement about the center of the iris diaphragm 50.
  • Claws 59, 59' on the lamellae 53, 53 ', 53" engage in corresponding lamellae lanes 58 in the adjusting disk 54 a.
  • the lamellae 53, 53 ', 53 are thus designed and arranged such that the orientation of the lamellae 53, 53', 53" can be changed by the movement of the adjusting disk 54.
  • the slats can take at least two positions.
  • the fins 53, 53 ', 53 "have inner walls 66 which act as electrodes.
  • Fig. 9 are the slats 53, 53 'positioned so that they hardly protrude beyond the adjusting disc 54. It forms a circular passage opening into which the sleeve 32 protrudes. Between the sleeve 32 and the Inner edges 66 of the fins 53, 53 'is a gap which is suitable for receiving portions of the hollow organs.
  • the passage opening is reduced in size such that the inner edges 66 of the lamellae 53, 53 ', 53 "rest on the sleeve 32 (cf. Fig. 8 ).
  • tissue sections of the hollow organs between the inner edges of the fins 53, 53 ', 53 "and the sleeve 32 they are pressed together with a predefined force against each other and against the sleeve 32. This force can be adjusted with the Sch Schweizerkrafteinstellvortechnisch 45 and is on the Control elements 52, 52 'on the fins 53, 53', 53 "transmitted.
  • the covers 55, 55a are mutually arranged on the half panels 51, 51 'and protect their mechanics.
  • Fig. 7 shows a further embodiment of the fins 53, 53 '. These are designed in a stepped manner and close in such a way that a first louver 53 not only slides up onto the second louver 53 'during the closing process, but also engages in the latter.
  • FIG. 10 Another embodiment of the blades 53, 53 'can be the 10 and 11 remove.
  • the 10 and 11 show the iris diaphragm 50 according to the invention in plan view, wherein the iris diaphragm 50 in Fig. 10 closed and in Fig. 11 is open.
  • the cover 55 ' is in FIG Fig. 10 away. It can be seen that the lamellae 53, 53 'engage via T-armature 59a, 59a' in the slotted guide 58 of the adjusting disk 54.
  • Pins which are arranged on the adjusting disc 54 of the half-diaphragms 51, 51 'and project into the covers 55, 55' form a slotted guide for the adjusting discs 54. They guide the adjusting discs 54 in their rotational movement about the center of the iris diaphragm 50 and thereby increase the closing area of the slats.
  • the Fig. 12 to 14 show a further embodiment of the mechanism of the iris diaphragm 50 according to the invention with a simpler structure.
  • a coordinate system is introduced.
  • the X-axis of this coordinate system extends substantially along an industry sector 12.
  • the Y-axis is transverse thereto and points to the center of the passage opening of the iris diaphragm 50.
  • the Fig. 12 shows by way of example the first half-stop 51 in an exploded view.
  • An essential difference of the embodiment according to the Fig. 12 to 14 opposite to the Fig. 6 is that the function of the adjusting disk 54 in the embodiments of the Fig. 12 to 14 by a lamella 53 to 53 ", namely the lamella 53 'is perceived Fig. 12 also firmly connected to the first industry 12. It comprises three recesses 61, 61 ', 61 ", which are opened radially in the direction of the center of the passage opening of the iris diaphragm 50.
  • these recesses 61, 61', 61" are mounted lamellae pins 63, 63 ', 63 " Essentially arranged centrally on the fins 53, 53 '53 ".
  • the recesses 61, 61 ', 61 form a slotted guide along which the individual slats 53, 53'53” can be moved to the center of the passage opening.
  • the louver pins 63, 63 ', 63 are formed on both sides of the louvers 53, 53', 53". They engage on the one side in the recesses 61, 61 ', 61 "of the mounting plate 56 and on the other side of the fins 53, 53', 53” in recesses 65, 65 ', 65 “of the cover 55.
  • the recesses 65th , 65 ', 65 "of the covers 55 also extend substantially toward the center of the through hole of the iris diaphragm 50.
  • the blade 53 ' is rigidly connected to the actuator 52 and has for this purpose a corresponding extension.
  • the actuator 52 is actuated along the Y axis.
  • the semicircular louvers 53 to 53 "have at their ends in each case a recess 64, 64 ', 64", 64 “', which engage in the pins 63, 63 ', 63" of the other lamellae 53 to 53 " mechanical coupling between the first blade 53 and the second blade 53 '(recess 64, 64') which in turn is connected to the third blade 53 "(recess 64", 64 "').
  • Movement of the second louver 53 'along the Y-axis actuates and displaces the first and third louvers 53, 53 ", and the slide guides are configured to move each of the louvers 53 to 53" toward the center of the through-hole. when the second louver 53 'is shifted along the Y-axis. By a counter-movement of the second blade 53 ', this movement can be reversed.
  • the iris diaphragm 50 opens.
  • the second half-aperture is correspondingly symmetrical.
  • the FIGS. 13 and 14 show the half-panels 51, 51 '. It can be seen that, in a closed state of the electrosurgical instrument 10, the first louver 53 of the first half-stop 51 makes a mechanical connection with the lamination 53 "" opposite it. received. There is also a connection between the lamellar pins 63, 63 ', 63 "and the recesses 64, 64', 64". The same applies to the third slat 53 ".
  • the coupling of the lamellae 53 to 53 "of the first half-stop 51 with that of the second half-stop 51 is detachable.
  • the iris diaphragm 50 has a gap through which the connected hollow organ can be separated from the instrument 10.
  • the closed state of the electrosurgical instrument 10 thus forms a ring of fins 53 to 53 "", which according to the embodiment of Fig. 12 to 14 includes six lamellae.
  • the individual lamellae 53-53 '' are in each case in operative connection with the lamellae 53-53 '' adjacent to them.
  • a slotted guide is formed which permits a translational movement of the individual slats 53 to 53 '' in the direction of the center of the passage opening, ie the actuation of the adjusting elements 52, 52 'is transmitted mechanically to the individual slats 53 to 53''' ,
  • the iris diaphragm 50 comprises a first outer electrode arrangement or outer electrode, the sleeve 32 an inner electrode arrangement, namely the sleeve electrode 36. As in the Fig. 5 As shown, these electrodes are arranged adjacent to each other. The portions of hollow organs which are clamped between the iris diaphragm 50 and the sleeve 32 can be connected to each other by means of these electrodes. For this purpose, a corresponding HF current is applied to the electrodes. The RF current coagulates the tissue sections located between the electrodes. In order to apply the HF current, the electrosurgical instrument 10 has corresponding conductor tracks and connections. For example, the sleeve electrode 36 may be powered via a trace within the sleeve actuating industries 55, 55 '. A corresponding track for the iris can be located within the branches 12, 12 '.
  • branches 12, 12 'and / or the sleeve actuation branches 53, 53' may be formed wholly or partly of electrically conductive material in order to provide a corresponding trace.
  • the individual lamellae 53 to 53 '" may comprise electrodes for application of the HF current and / or be formed of electrically conductive material.
  • the base plate 13 and the detachable portion 13 'of the base plate 13 is an electrical insulator.
  • the conductor track of the sleeve electrode 36 is at least electrically insulated from the conductor track of the iris diaphragm 50.
  • the base plate 13 and / or the removable portion 13 ' may include terminals and electrical traces to supply the electrodes.
  • Embodiments with four and eight blades 53 to 53 “” have been described. Further embodiments with a different number of lamellae 53 to 53 “” are conceivable (eg with at least four lamellae 53 to 53 “”).

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Surgical Instruments (AREA)
EP09777405.3A 2008-08-19 2009-07-23 Vorrichtung zur herstellung von anastomosen sowie koagulationselektrode Not-in-force EP2341861B1 (de)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP13191846.8A EP2710973B1 (de) 2008-08-19 2009-07-23 Koagulationselektrode
PL13191846T PL2710973T3 (pl) 2008-08-19 2009-07-23 Elektroda koagulacyjna
PL09777405T PL2341861T3 (pl) 2008-08-19 2009-07-23 Urządzenie do wytwarzania anastomoz i elektroda koagulacyjna

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE102008038313 2008-08-19
DE102008048293A DE102008048293B3 (de) 2008-08-19 2008-09-22 Vorrichtung zur Herstellung von Anastomosen sowie Koagulationselektrode
PCT/EP2009/005365 WO2010020328A1 (de) 2008-08-19 2009-07-23 Vorrichtung zur herstellung von anastomosen sowie koagulationselektrode

Related Child Applications (2)

Application Number Title Priority Date Filing Date
EP13191846.8A Division EP2710973B1 (de) 2008-08-19 2009-07-23 Koagulationselektrode
EP13191846.8A Division-Into EP2710973B1 (de) 2008-08-19 2009-07-23 Koagulationselektrode

Publications (2)

Publication Number Publication Date
EP2341861A1 EP2341861A1 (de) 2011-07-13
EP2341861B1 true EP2341861B1 (de) 2014-02-26

Family

ID=41112141

Family Applications (2)

Application Number Title Priority Date Filing Date
EP09777405.3A Not-in-force EP2341861B1 (de) 2008-08-19 2009-07-23 Vorrichtung zur herstellung von anastomosen sowie koagulationselektrode
EP13191846.8A Not-in-force EP2710973B1 (de) 2008-08-19 2009-07-23 Koagulationselektrode

Family Applications After (1)

Application Number Title Priority Date Filing Date
EP13191846.8A Not-in-force EP2710973B1 (de) 2008-08-19 2009-07-23 Koagulationselektrode

Country Status (7)

Country Link
US (2) US9011469B2 (ja)
EP (2) EP2341861B1 (ja)
JP (1) JP5421991B2 (ja)
CN (1) CN102123676B (ja)
DE (1) DE102008048293B3 (ja)
PL (2) PL2341861T3 (ja)
WO (1) WO2010020328A1 (ja)

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8348128B2 (en) * 2009-11-11 2013-01-08 Biorep Technologies, Inc. Anastomosis system and method
IT1399861B1 (it) * 2010-04-30 2013-05-09 I & S Idee & Sviluppo S R L Applicatore di griffe per giunti vascolari termino - terminali
DE102010035470B4 (de) 2010-08-26 2015-08-13 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Vorrichtung zum Durchführen einer Seit-zu-Seit- Anastomose
DE102012107919A1 (de) 2012-08-28 2014-05-15 Aesculap Ag Elektrochirurgisches Instrument zur Herstellung einer End-zu-End-Anastomose
KR101809389B1 (ko) 2013-10-10 2017-12-14 슈나이더 일렉트릭 인더스트리스 에스에이에스 회로 차단기 장치

Family Cites Families (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH525668A (de) * 1970-01-14 1972-07-31 Ceskoslovenska Akademie Ved Vorrichtung zur nahtlosen Verbindung der Enden eines unterbrochenen, schlauchförmigen Organs bei chirurgischen Operationen
US3774615A (en) 1971-02-08 1973-11-27 Ceskoslovenska Akademie Ved Device for connecting or joining the ends of interrupted tubular organs in surgical operations without stitching
US4892098A (en) * 1985-06-26 1990-01-09 Sauer Jude S Tubular tissue welding device without moving parts
US5188638A (en) * 1992-02-06 1993-02-23 Tzakis Andreas G Apparatus and method for preforming anastomosis fastener securement of hollow organs
US6626901B1 (en) * 1997-03-05 2003-09-30 The Trustees Of Columbia University In The City Of New York Electrothermal instrument for sealing and joining or cutting tissue
JP3766520B2 (ja) * 1997-10-06 2006-04-12 オリンパス株式会社 血管吻合装置
US20070276363A1 (en) * 1998-02-12 2007-11-29 Boris E. Paton Instrument and method for the end-to-end reconnection of intestinal tissues
US6562037B2 (en) * 1998-02-12 2003-05-13 Boris E. Paton Bonding of soft biological tissues by passing high frequency electric current therethrough
US6527767B2 (en) * 1998-05-20 2003-03-04 New England Medical Center Cardiac ablation system and method for treatment of cardiac arrhythmias and transmyocardial revascularization
US6599302B2 (en) * 1998-06-10 2003-07-29 Converge Medical, Inc. Aortic aneurysm treatment systems
JP2001037770A (ja) * 1999-07-28 2001-02-13 Olympus Optical Co Ltd 超音波処置具
JP2003061973A (ja) * 2001-08-27 2003-03-04 Olympus Optical Co Ltd 超音波組織溶着装置
AT411216B (de) * 2002-01-25 2003-11-25 Schubert Heinrich Dr Vorrichtung zur herstellung von anastomosen zwischen hohlorganen
WO2003096918A1 (en) * 2002-05-15 2003-11-27 Kevin Marchitto Method and device for anastomoses
DE10350709A1 (de) * 2003-10-30 2005-08-18 Erbe Elektromedizin Gmbh Vorrichtung zur Koagulation von Gewebe
ITBO20030782A1 (it) * 2003-12-23 2005-06-24 New Age Const And Engineeri Ng S P A Dispositivo e metodo per anastomosi.
ATE516762T1 (de) * 2004-06-02 2011-08-15 Medtronic Inc Ablations- und klammerinstrument
DE102009032972A1 (de) * 2009-07-14 2011-01-20 Erbe Elektromedizin Gmbh Vorrichtung zur Herstellung von Anastomosen
DE102009027813A1 (de) * 2009-07-17 2011-01-27 Celon Ag Medical Instruments Anastomosering und Anastomoseringanordnung
DE102009059195A1 (de) * 2009-12-17 2011-06-22 Aesculap AG, 78532 Chirurgisches System zum Verbinden von Körpergewebe und Verfahren zum Abtrennen überstehenden Gewebes

Also Published As

Publication number Publication date
EP2341861A1 (de) 2011-07-13
US9186147B2 (en) 2015-11-17
PL2341861T3 (pl) 2014-07-31
JP2012500068A (ja) 2012-01-05
US20150257812A1 (en) 2015-09-17
CN102123676B (zh) 2013-07-03
US20110152862A1 (en) 2011-06-23
EP2710973B1 (de) 2015-01-14
EP2710973A1 (de) 2014-03-26
WO2010020328A1 (de) 2010-02-25
US9011469B2 (en) 2015-04-21
CN102123676A (zh) 2011-07-13
DE102008048293B3 (de) 2009-10-29
JP5421991B2 (ja) 2014-02-19
PL2710973T3 (pl) 2015-05-29

Similar Documents

Publication Publication Date Title
EP2890307B1 (de) Elektrochirurgisches instrument zur herstellung einer end-zu-end-anastomose
DE602004006218T2 (de) Behandlungsinstrument für Endoskop
EP2512358B1 (de) Chirurgisches system und steuerungsverfahren für ein chirurgisches instrument zum verbinden von körpergewebeteilen
EP3097870B1 (de) Chirurgisches system zum verbinden von körpergewebe
EP2103264B1 (de) Medizinisches Instrument
EP2911595B1 (de) Anastomoseinstrument mit schwenkbarem amboss
EP2341861B1 (de) Vorrichtung zur herstellung von anastomosen sowie koagulationselektrode
DE202010013151U1 (de) Chirurgisches System zum Verbinden von Körpergewebe
EP2775941B1 (de) Anastomosegerät mit kollabierbarem distalem kopfelement
EP1319372B1 (de) Vorrichtung zum Halten von Trokarhülsen
EP3334351A1 (de) Vorrichtung zur durchtrennung von gewebeteilen
EP0696901B1 (de) Endoskopische schneidvorrichtung
DE2734847A1 (de) Koagulationszange
EP3066997B1 (de) Endoskopische vorrichtung
EP2453805B1 (de) Vorrichtung zur herstellung von anastomosen
EP3772345B1 (de) Vorrichtung zur simultanen fixierung von medizinischen instrumenten und entsprechendes system
DE102012103501B4 (de) Chirurgisches Gerät zur Herstellung einer Tabaksbeutelnaht
DE112008000878T5 (de) Behandlungssystem und Behandlungsgerät
WO2019180048A1 (de) Vorrichtung zur freilegung und offenhaltung eines operationsgebietes
EP2837342B1 (de) Endoskopisches Instrument
DE102012109387A1 (de) Chirurgisches Instrument und insbesondere elektrochirurgisches Instrument
DE102015103913A1 (de) Hohlschaftinstrument und insbesondere medizinisch-endoskopisches Hohlschaftinstrument
DE102021107174A1 (de) Antriebsschaft für ein chirurgisches Instrument
DE202011051933U1 (de) Chirurgisches Instrument
DE102012220973A1 (de) Endoskopisches Instrument

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20110316

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO SE SI SK SM TR

AX Request for extension of the european patent

Extension state: AL BA RS

DAX Request for extension of the european patent (deleted)
17Q First examination report despatched

Effective date: 20130319

GRAP Despatch of communication of intention to grant a patent

Free format text: ORIGINAL CODE: EPIDOSNIGR1

INTG Intention to grant announced

Effective date: 20130909

GRAS Grant fee paid

Free format text: ORIGINAL CODE: EPIDOSNIGR3

GRAA (expected) grant

Free format text: ORIGINAL CODE: 0009210

AK Designated contracting states

Kind code of ref document: B1

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO SE SI SK SM TR

REG Reference to a national code

Ref country code: GB

Ref legal event code: FG4D

Free format text: NOT ENGLISH

REG Reference to a national code

Ref country code: CH

Ref legal event code: EP

REG Reference to a national code

Ref country code: AT

Ref legal event code: REF

Ref document number: 653096

Country of ref document: AT

Kind code of ref document: T

Effective date: 20140315

REG Reference to a national code

Ref country code: IE

Ref legal event code: FG4D

Free format text: LANGUAGE OF EP DOCUMENT: GERMAN

REG Reference to a national code

Ref country code: DE

Ref legal event code: R096

Ref document number: 502009008869

Country of ref document: DE

Effective date: 20140410

REG Reference to a national code

Ref country code: NL

Ref legal event code: VDEP

Effective date: 20140226

REG Reference to a national code

Ref country code: LT

Ref legal event code: MG4D

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: NO

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140526

Ref country code: LT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: IS

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140626

REG Reference to a national code

Ref country code: PL

Ref legal event code: T3

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: PT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140626

Ref country code: SE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: CY

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: NL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: FI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: HR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: LV

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: RO

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: DK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: EE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: CZ

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

REG Reference to a national code

Ref country code: DE

Ref legal event code: R097

Ref document number: 502009008869

Country of ref document: DE

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: ES

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

PLBE No opposition filed within time limit

Free format text: ORIGINAL CODE: 0009261

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT

26N No opposition filed

Effective date: 20141127

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LU

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140723

REG Reference to a national code

Ref country code: CH

Ref legal event code: PL

REG Reference to a national code

Ref country code: DE

Ref legal event code: R097

Ref document number: 502009008869

Country of ref document: DE

Effective date: 20141127

REG Reference to a national code

Ref country code: IE

Ref legal event code: MM4A

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: CH

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20140731

Ref country code: LI

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20140731

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: IE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20140723

REG Reference to a national code

Ref country code: AT

Ref legal event code: MM01

Ref document number: 653096

Country of ref document: AT

Kind code of ref document: T

Effective date: 20140723

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: AT

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20140723

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SM

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: MC

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: MT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: BG

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: GR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140527

REG Reference to a national code

Ref country code: FR

Ref legal event code: PLFP

Year of fee payment: 8

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: BE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140731

Ref country code: TR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

Ref country code: HU

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT; INVALID AB INITIO

Effective date: 20090723

REG Reference to a national code

Ref country code: FR

Ref legal event code: PLFP

Year of fee payment: 9

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: IT

Payment date: 20170720

Year of fee payment: 9

Ref country code: GB

Payment date: 20170728

Year of fee payment: 9

Ref country code: FR

Payment date: 20170727

Year of fee payment: 9

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: PL

Payment date: 20170707

Year of fee payment: 9

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: DE

Payment date: 20170929

Year of fee payment: 9

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: MK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20140226

REG Reference to a national code

Ref country code: DE

Ref legal event code: R119

Ref document number: 502009008869

Country of ref document: DE

GBPC Gb: european patent ceased through non-payment of renewal fee

Effective date: 20180723

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: FR

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180731

Ref country code: GB

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180723

Ref country code: DE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20190201

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: IT

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180723

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: PL

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180723